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Despite wide dissemination of practice guidelines, diabetes care remains suboptimal, perhaps as a result of inadequate identification of patients at risk,1 insufficient medication adjustments,2,3 and poor knowledge of practice guidelines.2,4
Efforts to improve delivery of care to people with diabetes should ideally involve all community-based providers. One such provider is the community pharmacist, who is ideally placed in the health care system to provide care for these individuals. In fact, it has been suggested that people with diabetes visit their pharmacist five times more often than other health care providers.5 However, empiric measurement of these opportunities for care (visits to health care professionals) has not been described. The purpose of this study was to quantify the opportunities for care of patients with diabetes in the community by pharmacists and physicians.
Research design and methods
All Saskatchewan residents with diabetes in 2001 were identified from the administrative databases of Saskatchewan Health using the standard National Diabetes Surveillance System case definition.6 Insured prescription drug dispensations and physician service claims data for these individuals during 2001 were obtained from the administrative databases.
A pharmacist visit was defined as a day in which one or more dispensations occurred, while a physician visit was defined as a day in which one or more physician service claims were recorded. Physician visits were stratified by general practitioner and specialist. Data were stratified by large urban (population larger than 100,000), small urban, and rural centres (population smaller than 5000). Burden of disease was estimated using the chronic disease score (CDS).7,8 A paired sign test was used to evaluate differences in pharmacist and physician visit frequency, where p...